title: Reverse masquerade syndrome: fungal adnexal infection mimicking carcinoma in a HIV-positive patient.
abstract: A known HIV-positive male patient presented with a rapidly progressive ulcerative lesion involving the conjunctiva, lids, and anterior orbit along with a decrease in vision in the right eye. He was on anti retro-viral and anti-tubercular therapy. In view of the clinical features, our provisional clinical diagnosis was a malignant lesion of the eyelid with orbital involvement, possibly squamous cell carcinoma. However, incisional biopsy revealed absence of malignant cells. On Gomori Methenamine Silver staining, plenty of fungal filaments were seen, which was confirmed by culture as Candida albicans. Hence, it turned out to be a case of fungal adnexal infection mimicking carcinoma in a HIV-positive patient. The patient responded well to systemic anti-fungals.
authors.affiliation: Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India.
authors.forename: Bipasha
authors.initials: B
authors.lastname: Mukherjee
authors.forename: Raka
authors.initials: R
authors.lastname: Chatterjee
authors.forename: Jyotirmay
authors.initials: J
authors.lastname: Biswas
mesh_terms: D001706:Biopsy; D002176:Candida albicans / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis* / Q000382:microbiology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D003937:Diagnosis, Differential; D015821:Eye Infections, Fungal / Q000175:diagnosis* / Q000382:microbiology; D005141:Eyelid Diseases / Q000175:diagnosis* / Q000382:microbiology; D005142:Eyelid Neoplasms / Q000175:diagnosis*; D005143:Eyelids / Q000382:microbiology* / Q000473:pathology; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013577:Syndrome